Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, Copenhagen, Denmark.
University of Copenhagen, Copenhagen, Denmark.
Cephalalgia. 2024 May;44(5):3331024241248203. doi: 10.1177/03331024241248203.
Idiopathic intracranial hypertension is a secondary headache disorder potentially causing visual loss. Neurofilament light chain is a candidate, prognostic biomarker, but further studies of neuronal biomarkers are needed. Our objective was to investigate neurofilament light chain in cerebrospinal fluid (cNfL) and plasma (pNfL), amyloid-beta 42 (Aβ-42), total-tau and phosphorylated-tau in cerebrospinal fluid in new-onset idiopathic intracranial hypertension.
Prospective case-control study including new-onset idiopathic intracranial hypertension and age, sex and BMI matched controls. Biomarkers were compared between patients and controls and related to papilledema, visual fields and opening pressure.
We included 37 patients and 35 controls. Patients had higher age-adjusted cNfL (1.4 vs. 0.6 pg/mL, p-adjusted < 0.001), pNfL (0.5 vs. 0.3 pg/mL, p-adjusted < 0.001) and total-tau/Aβ-42 (0.12 vs. 0.11, p-adjusted = 0.039). Significant, positive linear correlations were found between cNfL, pNfL, total-tau/Aβ-42 and opening pressure. Patients with severe papilledema had elevated cNfL compared to mild-moderate papilledema (median cNfL: 4.3 pg/mL (3.7) versus 1.0 pg/mL (1.4), p-adjusted = 0.009). cNFL was inversely associated with perimetric mean deviation (r = -0.47, p-adjusted < 0.001).
cNfL, pNfL and total-tau/Aβ-42 were elevated in new-onset idiopathic intracranial hypertension. cNfL was associated with severity of papilledema and visual field defects at diagnosis. This indicates early axonal damage. Neurofilament light chain is a candidate biomarker for disease severity.
特发性颅内高压是一种潜在导致视力丧失的继发性头痛疾病。神经丝轻链是一种候选的预后生物标志物，但需要进一步研究神经元生物标志物。我们的目的是研究新诊断的特发性颅内高压患者的脑脊液（cNfL）和血浆（pNfL）中的神经丝轻链、β-淀粉样蛋白 42（Aβ-42）、总 tau 和磷酸化 tau。
前瞻性病例对照研究，纳入新诊断的特发性颅内高压患者和年龄、性别和 BMI 匹配的对照组。比较患者和对照组之间的生物标志物，并与视乳头水肿、视野和开放压相关。
我们纳入了 37 例患者和 35 例对照组。患者的年龄校正后 cNfL（1.4 vs. 0.6 pg/mL，p 调整 < 0.001）、pNfL（0.5 vs. 0.3 pg/mL，p 调整 < 0.001）和总 tau/Aβ-42（0.12 vs. 0.11，p 调整 = 0.039）更高。cNfL、pNfL、总 tau/Aβ-42 与开放压呈显著正线性相关。严重视乳头水肿的患者 cNfL 高于轻度至中度视乳头水肿的患者（中位数 cNfL：4.3 pg/mL（3.7）与 1.0 pg/mL（1.4），p 调整 = 0.009）。cNFL 与周边平均偏差呈负相关（r = -0.47，p 调整 < 0.001）。
新诊断的特发性颅内高压患者的 cNfL、pNfL 和总 tau/Aβ-42 升高。cNfL 与诊断时视乳头水肿和视野缺损的严重程度相关。这表明早期轴索损伤。神经丝轻链是疾病严重程度的候选生物标志物。
